The Main Etiologies For Patients Presented To ER With Chest Pain Or Chest Pain Equivalent In BeiJing

Objectives: To identify the mian etilogoies for patients presented to the ER with chest pain or chest pain equivalent and further analyze the common presenting symptom of coronary heart disease patients in the ER Methods: We conducted a prospective ,cross-sectinal survey of all patinets presented to the ER with chest pain and chest pain equivalent syndrome in 17 medical centre in Beijing,China from July to August 2009.Data was collected by structured interviews and medical record reviews.The mean follow up period was 30 days.Results: A total of 5666 patients entered the study (age58.09±18.39,2663 males and 3303 females)Their final diagnoses are:Chest pain(4.65%) Coronary heart disease 1506(27.4%),Acute Heart failure 149 ( 2.6% ) ,Pericarditis 4 ( 0.1% ) ,Pulmonary embolism 11(0.2%),Aortic dissection8(0.1%),Acute cerebrovascular disease 431(7.6%),Non-cardic chest pain 2538(44.9%)We further analyzed the cornary heart disease patients.Eight-eight percent patients with cornary heart disease have symptoms at their presentation..The other 12% patients without symptom. 71% with chest prseur sensation.38.8% with shorness of breath,23.3%with dyspnea,33.2% Palpitation , 22.0% dizziness,14.7% nausea and vomiting ,19.1% sluggish , 2.7% irritable , 1.6% syncope,1.0% Loss of ConsciousnessConclusions: Patients with ACSs who present without chest pain are frequently misdiagnosed and undertreated. In this study,Nearly half(48.8%) of the coronary heart disease patients present with no chest pain and 18.7%CHD patients presents with chest pain equivalent syndrome.With the exception of diaphoresis ,each dominant presenting symptom independently identifies a population that is at increased risk of dying.These patients ecperience greater morbidity and a higher mortality across the spectrum of ACSs. Therefore,special vigilance and thorough coronary artery evaluation is needed for all patients with chest discomfort or respiratory distress in the ER,even for patients without chest pain complaints.